A 23-year-old woman has spoken publicly about a troubling reaction she links to a widely prescribed class of antidepressants, as a doctor urges patients to be aware of the possible risks.
Lauren Friedman, a student at Vanderbilt University, says the medication left her feeling emotionally and physically disconnected, describing the experience as losing important sensations tied to intimacy and affection.
She argues that she was not in a position to fully understand the potential consequences when she started taking medication intended to raise serotonin levels.
These medicines are known as SSRIs, or selective serotonin reuptake inhibitors. They are commonly used to treat conditions including depression, anxiety, OCD, panic disorder and PTSD, and are designed to increase serotonin, a chemical associated with mood regulation.
Commonly prescribed SSRIs include sertraline, sold under the brand name Zoloft, along with fluoxetine, citalopram, escitalopram, paroxetine and fluvoxamine. Sexual side effects are already listed as known risks for this class of drugs, with patient information for SSRIs warning that some people may experience reduced libido, delayed orgasm or an inability to reach orgasm.
Friedman says her problems began after taking Zoloft in 2022, and that since then she has struggled with sexual pleasure, orgasm, and emotional closeness.
“I can’t feel love for my own mother, which is the hardest thing on Earth,” she said in an “Overmedicalization of Mental Health” event in Washington on May 4, which was hosted by the MAHA Institute.
Her symptoms are associated with post-SSRI sexual dysfunction, or PSSD, a condition reported by some people after taking these drugs. The term is generally used when sexual symptoms continue after the medicine has been reduced or stopped, rather than only while someone is actively taking it.
The issue is also referred to as anorgasmia in some cases, though that word more specifically means delayed, less intense or absent orgasm and can have many different causes. According to Ubie Health, difficulty reaching orgasm can also be linked to other medications, including antipsychotics, blood pressure drugs, opioid painkillers, hormone-based treatments, and certain anti-seizure medications.
Medical experts say that makes diagnosis complicated, because sexual dysfunction can also be related to depression itself, anxiety, relationship problems, alcohol use, smoking, chronic illnesses, hormonal changes, past trauma and other medicines. That means patients who develop symptoms often need a full review rather than assuming there is one single cause.
Dr Kenneth Peters, chief of urology at Corewell Health in Southeast Michigan, said the condition can be especially alarming because symptoms may continue even after the medication has been stopped.
“Most of us expect if we’re on a drug and have side effects, we stop the drug, we stop the side effects, but it’s the opposite of this,” said Dr Kenneth Peters, chief of urology at Corewell Health in Southeast Michigan.
He explained that the effects can vary widely from person to person. Physical symptoms may include genital numbness, erectile difficulties, reduced lubrication, or problems achieving orgasm, and in some cases these complaints persist beyond treatment.
Friedman believes the impact may be permanent, which is why she has described it as a form of chemical castration.
Peters added that some patients also report changes involving bowel and bladder function, along with a loss of emotional connection to activities or people that once mattered deeply to them.
“It is a striking thing when you see it as a clinician,” he said to USA Today.
Although the European Medicines Agency formally moved in 2019 to update product information for SSRIs and SNRIs to warn that, in some cases, symptoms of sexual dysfunction may continue after treatment stops, PSSD is still not a formally recognised diagnosis in major US diagnostic manuals.
That gap has helped fuel debate over how common the problem is and how it should be defined. Reviews in medical journals describe PSSD as under-researched, and there is currently no universally accepted test or proven standard treatment.
Peters said that lack of recognition can leave patients feeling ignored or doubted when they seek help.
“I think most patients get their medical information off of subreddit accounts, where people who have this, who tried a million different things talk about their experience,” he said.
At the same time, he stressed that SSRIs can still be beneficial and even critical for some people dealing with serious mental health conditions, so conversations about the risks should be handled carefully.
“You don’t want to scare people from taking something that could be potentially life-saving for them either,” Peters said.
Doctors generally advise people not to stop antidepressants suddenly without medical guidance, because doing so can cause withdrawal-like symptoms and can also increase the risk that depression or anxiety symptoms return. Anyone who develops distressing sexual side effects while taking an SSRI is usually advised to speak to a doctor or pharmacist about whether dose changes, switching medicines, waiting to see if symptoms ease, or other supportive treatment options might help.